The Lowdown on PMS
Pre-Menstrual Syndrome (PMS) gained lots of interest when there were some studies in the 70s and the 80s that suggested a link between females committing crimes and PMS. In both the US and in the UK PMS has been used as a defence for criminal offences.
Before you get any ideas though, note that in Australia PMS has never been used as a defence or a partial defence.
There are numerous jokes, memes and comments about PMS but the reality is that there are a number of women that suffer every month because of PMS and they think that it is ok and they have to put up with it.
It’s really not OK and often there are solutions and sometimes, it might not even be PMS at all.
Why do we get PMS?
This is not a straightforward answer because there a number of biochemical processes that happen around our menstrual cycle and all of them can contribute but I’ll do my best to sum it up.
- Fluctuating hormone levels of progesterone and oestrogen.
Our hormones naturally fluctuate across our cycle, they have to in order for our bodies to do the amazing job it does and have the potential to grow a baby. Just before your period you experience a drop in both progesterone and oestrogen. Both of these hormones have a really strong impact on your brain and nervous system and some women are more sensitive to this than others. If your progesterone drops faster than your oestrogen or you didn’t have a whole lot of progesterone to begin with, then this can mean that there is relatively more of one than the other. Its not that oestrogen is bad for us, it’s just that it’s supposed to be counterbalanced by progesterone. When it’s not, it can result in moodiness, sleep issues, migraines and irritability. For some women it’s the drop of both that cause the symptoms.
- Overstimulated inflammation processes
Couple of big words there but the meaning is pretty simple. There has to be some inflammation in order for you to menstruate, it triggers the uterine lining to shed which then becomes our period. If there is too much of the inflammatory substance produced though it can cause pain and cramps. If there is already a lot of inflammation in your body then this just adds up and can increase the pain that you feel before a period.
- Chronic stress
Stress probably needs its own blog really but the upshot is that when you are chronically stressed then the release of all of those stress hormones can inhibit the making of progesterone and then you end up the issue of oestrogen being in a relatively higher state compared to progesterone. Stress also means that the nervous system is on high alert so you tend to be more sensitive to pain when you a stressed. Plus, there are a bunch of other processes that are impacted by stress that can result in less feel-good chemicals being produced.
What Can You Do About PMS?
- Eat a wholefood diet
Lots of veg, good plant fats, some nuts and seeds and moderate protein. This does lots of things. Firstly, it provides the fibre that helps gut bacteria parcel up the hormones and send them to your bowel motion. Vegies also provide the nutrients to assist your liver to detoxify hormones as required. Vegies are also very anti-inflammatory so they can help dampen down some of that inflammation that can cause pain. Complex carbs like brown rice, oats, potatoes and sweet potatoes actually help your body make hormones. On a side note, vegies are the major source of fibre that our helpful bacteria use as food – given that our gut is a great source of the way feel good chemicals are made we want those helpful bacteria to thrive!
- Limit alcohol, caffeine and sugar
Alcohol does not help your liver and if you have PMS you need your liver to work well to process your hormones. It is also a stomach irritant so can affect your gut bacteria that we want to be of the beneficial kind. Caffeine is stimulant (as is sugar) so it can increase the nervous system activity which I mentioned can make you more pain sensitive and reduce your feel-good progesterone amounts. Sugar feeds our “bad” bacteria in our gut and this can contribute to bloating and poor mood as the bacteria that feed off sugar do not help make any feel good chemicals at all!
- Find a good Magnesium supplement
Magnesium is used for hundreds of chemical reactions in the body. It has a part to play in your body making feel good chemicals, in muscle relaxation, in reducing inflammation and pain, and in energy production (so cool that it can both help you relax and help with making energy – doesn’t the body just rock?). We rarely get enough in this day and age. Regarding quality supplements, I can tell you that the cheap supermarket brand quality will be unlikely to make a difference for you. This is a case of quality making a difference as some of the cheap supplements have fillers or forms of magnesium that will provide little benefit to you. They are also unlikely to be the right dosage for you as there is a very general and low dose suggested for most.
- Move your body
Study after study has shown us that exercise helps PMS symptoms. It appears that works through a combination of benefits. Exercise can help reduce inflammation (in the right amounts), produce feel good chemicals, build physical and mental resilience, change gut bacteria to the more beneficial kind. I am a BIG FAN of exercise for whole body health.
I dearly love acupuncture and Naturopathy working together for hormonal health. Its like a match made in heaven. I am not an acupuncturist so will not give the modality justice if I try to explain it but I can tell you that it is backed by studies (yes, I read them) and my own clinical observations and experience.
Look lets face it. A good massage is pretty amazing all round. From a “how does that work” perspective what we know is that it calms the nervous system, helps the production of those feel good chemicals that we love and by doing so can reduce inflammation and pain. (It does a bunch of other things too but those are the ones that are specific to PMS)
- See a Naturopath
Well, I am a Naturopath so I was always going to put this in!
Seriously though, we are so blessed in this modality to have herbs and nutrients that we can use to help women through PMS symptoms ranging from bloating, pain and moodiness. These have both traditional usage information and current studies behind them. We will also go over those lifestyle factors I mentioned above that can make such a difference and often there is a gut or liver focus, depending on the individual. Always a whole-body approach.
We may very recommend that you pursue further investigations medically too because there are cases when PMS is not actually PMS….
When PMS is not actually PMS
It really important for you to know that losing days of your life through pain, vomiting or severe diarrhoea before and during every period is not actually normal.
You may be suffering from endometriosis, a condition where the endometrium lining is found outside of the uterus area. Its generally characterised by very strong pain before periods.
The crappy thing is that it can only be diagnosed by a laparoscopy at this stage although there is good research going on to uncover another way.
It can 7 – 10 years for some women to get diagnosed and I think part of it is because we think we have to put up with the pain and get told that this is just the way it is. DO NOT GIVE UP. Keep seeking answers.
Similar to endometriosis in that the endometrium tissue is located where is shouldn’t be but in this case it is embedded in the wall or the muscle of the uterus rather than outside the uterus.
Adenomyosis is also characterised by very strong pain before periods but also heavy period bleeding.
Again, it can take time to diagnose because women think they have to put up with pain.
Premenstrual dysphoric disorder (PMDD)
This is a much more severe form of PMS which is characterised by sever menstrual depression, irritability or anxiety. Women find the symptoms debilitating and they interfere with work, school, social life and relationships.
In PMDD there is a different relationship with progesterone and the brain that can contribute to these symptoms.
The Bottom Line
- Don’t put up with pain
- There are solutions
- Seek help
Reach out if need.